Development of a drug and alcohol monitor

Research Period

1 February 2007 - 31 August 2007

Financing

Stad Antwerpen - SODA

Researcher

Julie TIEBERGHIEN

Key Words

local monitoring, ethnography, qualitative

Abstract

Reliable and relevant data for the benefit of the local drug policy are rare. Some data is available at the community or federal level. Local policy is faced with a lack of quantitative of qualitative data about the use of drugs and related problems.

Objectives

This study focuses on the need of a local drug monitoring system and evaluates the feasibility of such a system in the city Antwerp. The study had two aims: developing a scenario for the implementation of a community-based drug monitoring system and trying this system out.

Monitoring can be seen as a method to follow up trends and developments about a specific phenomenon, for example drug use. It's important that policymakers stay informed about the actual needs and problems in their city. A local drug monitor is an appropriate instrument for policymakers in the systematic and continuous collecting of data related to drug use. It informs them about the dynamics of the drug scene. A drug monitoring system collects information about drugs, drug users and related problems. The target population is the, so called, 'hidden populations', which are not known by the existing registration systems of police, justice or drug-treatment agencies. For local policymakers, such information can be very useful in developing an evidence-based policy.

Methodoloy

To gather information about this 'hidden populations', the local monitor consists of three qualitative parts: mobilization of 4 community fieldworkers, in-depth interviews with 40 key informants and ethnographic fieldwork. This methodology is based on an analysis of national and international literature concerning drug monitoring systems.

Results

The Antwerp Drug- and Alcohol Monitor (ADAM) mainly gained insight into the characteristics and lifestyle of 'hidden' marginalized drug users in the city of Antwerp because of the focus on daily (or almost daily) users of cocaine, heroin, amphetamines or benzodiazepines. Besides, also a group of frequent users, whereby use gradually leads to problems (e.g. loosing a job) is mapped.The definition of the target population, described above, also leads to a view of the (poly) drug use of the classic products (cocaine, heroin, amphetamines). By means of this local monitor, we were able to get insight into 'newer' products, for instance khat and ketamine. Furthermore, it became clear that the use of other products, like alcohol, medications or cannabis, may not be underestimated. Those products are often used to compensate for the (stimulating) effects of another drug or for the discontinuation of the use of cocaine, heroin or amphetamines.Additional, ADAM makes it possible to understand the most important health problems in the local drug scene. Users state that they take into account possible health risks, just like they are aware of the harm reduction messages, provided by several treatment centers. Nevertheless, that consciousness is rejected by the majority just before or during the consumption process. The assessment of the quality of the drugs remains a subjective perception. The quality of the drugs in the city Antwerp is still measured by drug users' perceptions. This means that drug users mostly use their drugs without knowledge of the correct level of purity. Thus, the risk of an overdose is real.The availability of the drugs in Antwerp is large, just like the financial accessibility. The prices of all products are, except for cannabis, decreased over the years. The price of cannabis remains rather stable.The Antwerp Drug- and Alcohol Monitor (ADAM) also indicates that drug users mostly are confronted with multi-problems concerning living and working conditions. In the case of living conditions, the city Antwerp is faced with high rental prices, a long waiting list for council estates and the lack of indoor relief at night. As the supply is limited, drug users take refuge with other users (and mostly in cramped conditions) or they search for squats. Thus, drug users are often obliged to survive in abominable conditions. A second problem concerns the source of income. In most cases, drug users are not able to work because of health problems or social isolation. They are unrelated to social structures and have difficulties to develop some routine. A lot of drug users need a useful spending of the day in order to face the loneliness and the boredom.ADAM also made it possible to reach some 'hidden populations'. With regard to those 'hidden populations' (users with an illegal status, ex-prisoners, foreign users, prostitutes, controlled users who already experienced some problems, people with a double diagnosis, etc.), we succeeded to discover why (or why not) they seek professional advice in drug treatment centers. For example, some users with an illegal status refuse to go to a treatment centre because they believe the social workers will inform the police. Other users (with an illegal status) seek for help but are refused because of a quotum or a language barrier. In the case of controlled drug users who already experience some problems, an association is made between assistance and 'junkies'. This group don't want to be compared with 'junkies'. Finally, by means of the local monitor we collected some impressions of several actual themes in the city Antwerp: large-scale police actions, the move of a treatment centre in the future and the effect of cameras on drug use.

Conclusion

The Antwerp Drug- and Alcohol Monitor (ADAM) yields a refined view of the local drug scene and related problems. These results make it possible to develop a well-founded local drug policy concerning prevention, harm reduction and treatment. Additionally, we want to stress that it is necessary to conduct this local monitor on a systematic and periodic way with a view to signalize trends an developments in the local drugscene.